All adults age 19-64 with income up to 138% of the Federal Poverty Level should apply for NJ FamilyCare. Parents/Caretaker Relatives For a household of four, 147% FPL in 2020 is $3,101 per month or $37,204 per year. Dependent children in the household must be insured also. Not currently pregnant or sterile. Medicaid • Aged, Blind and Disabled up to 100% FPL • Childless Adults up to 25% FPL . There is no waiting period if you have recently lost employment due to a reduction in staff. One important difference between the ABD programs and most other NJ FamilyCare programs is the method for calculating income. Click here for a printer friendly version . This is part of a regular process each year in which NJ FamilyCare income eligibility levels are updated based on increases in the federal poverty guidelines that are announced in January. (138% FPL). Even though New Jersey did not publish the 2020 income eligibility levels until late February, they are effective retroactively to January 1, 2020. Copays are usually $5-10 per visit or prescription. New Jersey FamilyCare FAQs Visit www.NJ FamilyCare.org for the latest news about New Jersey FamilyCare, state-approved, Quality Insurance program for children of New Jersey. First, the Division of Medical Assistance and Health Services (DMAHS) must approve your enrollment in our health plan. Rather, NJ FamilyCare is the umbrella name given to all of New Jersey’s health coverage programs for low-income residents. To be eligible for the NJ FamilyCare program, you must meet certain financial requirements. The income limits depend on … MAGI is calculated by taking an individual's adjusted gross income and adding back deductions taken for things like student loan interest, rental losses and tuition and fees. NJ FamilyCare is New Jersey's state and federally funded Medicaid program for eligible adults and children. Check back here for updates, changes, or added benefits in New Jersey FamilyCare plans NJ FamilyCare All Medicaid eligible Another category of NJ FamilyCare programs are those for the aged (65 and over), blind, and disabled (ABD). The NJ FamilyCare Aged, Blind, Disabled (ABD) Programs provides medical coverage to individuals who are age 65 years or older as well as individuals determined blind or disabled by the Social Security Administration or by the State of NJ. Need to register? Medicaid Eligibility and the Modified Adjusted Gross Income (MAGI) Method of Calculating Income​. Beginning October 1, 2013, ACA changes the Medicaid eligibility rules by streamlining the populations we cover under NJ FamilyCare which include: children, pregnant women, parents/caretaker relatives, single adults and childless couples. Our Hotline staff will be working remotely and you may encounter delays when calling. under this category. Medicaid is a wide-ranging, jointly funded state and federal health care program for individuals with limited income and resources, and is intended to assist individuals of all ages. This means that if you were denied or terminated from NJ FamilyCare in early 2020 for being slightly over the income limit, that determination may have been incorrect because it was based on outdated 2019 income limits. www.njejla.org, Use of this website signifies your agreement to our, NJ FamilyCare 2020 Income Eligibility Levels, If you are denied or terminated from any NJ FamilyCare program, make sure that the agency is using the 2020 (not 2019) income guidelines, and that the agency has also considered your eligibility for all other NJ FamilyCare programs. The central eligibility criterion is having income at or below 138% of the federal poverty level (FPL). Only certain NJ FamilyCare C and D members have copays. However, this page is focused strictly on long-term care Medicaid eligibility for New Jersey elderly residents who are 65 years of age and older. NJ FamilyCare • Families with income up to 133% of the federal poverty level (FPL) • Children in families with incomes up to 350% FPL • Pregnant Women up to 200% FPL . NJ FamilyCare provides health coverage to parents/caretakers and dependent children, pregnant women, and people who are aged, blind or disabled and/or those requiring long-term services and supports. Qualifying New Jersey residents of any age may be able to get free or low-cost health insurance through New Jersey's publicly funded health insurance program, NJ FamilyCare. For other medical assistance programs click here. On Feb. 19, 2020, the New Jersey agency that administers all NJ FamilyCare programs published income eligibility levels for 2020. www.lsnj.org MEDICAID TERMINATIONS BARRED DURING CORONAVIRUS EMERGENCY children, pregnant women, parents/caretaker relatives, and single adults/childless couples. Probably the most common NJ FamilyCare program is the ACA Medicaid Expansion for adults ages 19 to 64. So, if you or your children are not eligible for one NJ FamilyCare program, you may be eligible for another one. The NJ FamilyCare Integrated Eligibility System (NJFC IES) electronically verifies (in real time): social security number, citizenship, first name, last name, date of birth, death confirmation (if applicable) and identity through the Verification Tab. After . Adults without dependent children with ages 19-64 and income up to 138% FPL ($1,468/month for a single person and $1,983/month for a couple). See, Rooming/Boarding Houses and Mobile Home Parks, Forms for Lawsuits and Representing Yourself, Division of Child Protection and Permanency/Child Welfare, Rights Connected with Special Medical Problems, Deferred Action for Childhood Arrivals/DACA, Education Representation Project (ERP) brochure, Individual Tax Payer Identification Numbers/ITIN, Free Tax Preparation for Low-Income Tax Payers, Medicaid Eligibility and the Modified Adjusted Gross Income (MAGI) Method of Calculating Income​, The NJ FamilyCare Aged, Blind, Disabled Programs. The non-ABD programs generally use a method called “modified adjusted gross income” or MAGI, which uses basically the same rules used by the federal income tax system in calculating adjusted gross income. Managed Long Term Supports and Services (MLTSS) Who's eligible? Yes, if your health insurance is not accessible to your family, they may be eligible for NJ FamilyCare. This is called a deeming period. Open enrollment for this new eligibility group begins October 1, 2013. NJ FamilyCare health plans include Aetna Better Health of New Jersey, Amerigroup New Jersey, Horizon NJ Health, … If you are denied or terminated from any NJ FamilyCare program, make sure that the agency is using the 2020 (not 2019) income guidelines, and that the agency has also considered your eligibility for all other NJ FamilyCare programs. The NJ FamilyCare eligibility renewal process for members who are Aged, Blind and Disabled is different and requires different updates. Presumptive Eligibility Provider Training. Children in families with income up to 355% FPL ($7,751 per month or $93,010 per year for a household of four in 2020) are eligible for a NJ FamilyCare CHIP program, but their benefit package is less generous and parents pay a premium of $152 per month and co-pays ranging from $5 to $35. Pregnant Women up to 200% FPL. back to top. Qualifying Solely by Income. Section 10:49-2.9 - Medicaid or NJ FamilyCare-Plan A retroactive eligibility (a) Any person applying for Medicaid or NJ FamilyCare-Plan A benefits shall be asked if he or she has unpaid medical bills incurred within the three-month period immediately prior to the month of application for Medicaid or NJ FamilyCare-Plan A. Federal legislation passed on March 18, 2020 bars all Medicaid terminations during the course of the public health emergency caused by COVID-19. Since the ACA changes were implemented in 2014, you may qualify for Medicaid based solely on your income. The Affordable Care Act (ACA) Simplifies Medicaid Eligibility. cover under NJ FamilyCare which include: children, pregnant women, parents/caretaker relatives, single adults Financial eligibility will be determined by the latest federal tax return which, when filed, will be electronically verified. agreed to process retroactive Medicaid eligibility for all NJ FamilyCare/Medicaid applicants approved-'terthat date. new Medicaid Eligibility Expansion Group. Most health services are coordinated by one of five managed care organizations, or regional PACE providers, contracted with the Division of Medical Assistance and Health Services. Other NJ Family Care ABD programs, including the Medicaid Workability program and Long Term Care Medicaid (often referred to as MLTSS), have different income and resource limits. Your username should be the email address you used to register with this site. There are other NJ FamilyCare (Medicaid) programs for which eligibility is determined primarily based on disability or age (65 or over). The only other eligibility criteria are ineligibility for Medicare and certain immigration-related restrictions. (By contrast, 138% FPL in 2019 was $1,437 per month, or $17,237 per year.) For example, there is a “NewJersey Care” ABD program for persons with income up to 100% FPL, which, in 2020 is $1,064 per month or $12,760 for a single individual. During the COVID-19 pandemic the LSNJ Hotline will remain open during its normal business hours. You can appeal or file a new application, asking that your eligibility be reconsidered under the 2020 guidelines and restored retroactively to the month in which you originally applied. NJ FamilyCare includes: children, pregnant women, parents/caretaker relatives, single adults and childless couples. In determining whether a person is financially eligible for NJ FamilyCare ABD Programs, the applicant’s financial eligibility will be considered along with his or her spouse or parents. with income up to 133% FPL ($31,322 for a family of four) must have tax dependent children in their household in order to be eligible Children and parents may apply for NJ FamilyCare. What programs fall under the NJ FamilyCare label? Income Eligibility and Cost Medicaid Eligibility changes effective October 1, 2013 New federal rules change Medicaid eligibility by streamlining the populations we cover under NJ FamilyCare. Income Eligibility and Cost . For more information about MAGI, see SUBJECT: Income Eligibility Standards Effective January 1, 2020 . To be eligible, you must be without health insurance for at least three months. Click here for Spanish version of of this table. US Citizen or Qualified Immigrant. See NJ FamilyCare for more information about the NJ FamilyCare program, including how to apply. For a list of information that may be requested for eligibility renewal, click HERE HERE opens a dialog window‌. 2020 Income Limits See The NJ FamilyCare Aged, Blind, Disabled Programs (from the NJ Department of Human Services) for information specifically about NJ FamilyCare ABD programs, including how to apply. This application is for NJ FamilyCare programs (including Medicaid) for which eligibility is primarily based on income. Attached is the new income standards chart for all NJ FamilyCare programs. Eligibility for NJ FamilyCare is based on income and household size. You must also be a resident of New Jersey and be a U.S. citizen or have a qualified immigration status. Probably the most common NJ FamilyCare program is the ACA Medicaid Expansion for adults ages 19 to 64. The Affordable Care Act (ACA) Simplifies Medicaid Eligibility. Parents still need to renew the coverage each year. Use the ABD Checklist to see … NJ FamilyCare can show you how to do this. Keep your contact information updated. It includes people who qualify for Children’s Health Insurance Program (CHIP) or Medicaid. It includes all of New Jersey’s Medicaid and CHIP (Children’s Health Insurance Program) programs. After you apply, it may take between 30-45 days for your membership to start. NJ FamilyCare Rebranding . (b) A Medicaid or NJ FamilyCare Eligibility Identification Number consists of 12 digits, which includes a two digit Person Number. Beginning January 2014, NJ FamilyCare – New Jersey’s publicly funded health insurance program – includes CHIP, Medicaid and Medicaid expansion populations.
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